Quality Improvement

Quality Improvement (QI) is the Science of Process Management

Healthcare is made up of thousands of intertwined processes that result in an exceedingly intricate system. But, if we focus our efforts on the processes of care one at a time, we can ultimately drive sustained clinical improvement. Teams always acknowledge that there are opportunities throughout their health care systems to improve processes and eliminate waste, but with such a large, intricate system filled with so many interwoven processes, it’s challenging to decide on the starting point. What providers and their teams need is guidance to direct their efforts to where they will have the biggest impact on patient outcomes.

It has never been more important for health care providers and their teams to focus on Quality Improvement. Aside from the obvious top-ranking desire to provide the best care possible to patients, the payment model is undergoing a long overdue shift to focus more on the quality of health care being delivered. In order to maintain the highest reimbursement rates possible, providers will need to demonstrate that they are providing quality care to their patients. Failure to achieve quality health care delivery will result in reduced reimbursement rates.

On April 15, 2015, the Medicare Access & CHIP Reauthorization Act (MACRA) was passed, setting explicit goals for an alternate payment model and value-based payments. Medicare has set a 2016 goal of tying 30% of payments to quality or value through alternative payment models, by the end of 2018, 50% of payments will be tied to these models. One of these new value-based payment programs is the Merit Based Incentive Payment System (MIPS), which will rely heavily on performance measures. Historically, CMS has taken data from two years prior to tabulate penalties. Information on where providers stand with their Meaningful Use, PQRS and Value Based Modifier quality metrics from 2017 data will determine provider reimbursement rates in 2019.

Payment TIED Quality Graphic

Early Preparation for Reimbursement Changes Will Pay Off

This is where M-CEITA can help. As Michigan’s federally designated Regional Extension Center (REC), we work with Michigan providers to accelerate the selection, adoption, and meaningful use of health information technology to improve the quality and efficiency of care delivered in our state. M-CEITA is also committed to the Million Hearts® Initiative. Through our EHR adoption services, our staff works with providers to meet the rigorous demands of the clinical quality measures related to hypertension and diabetes. You can learn more about this at our new Health IT website: HITeLearningCenter.org

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